Con il termine sciatica si intende qualunque dolore provocato da irritazione o compressione del nervo sciatico: questo è il più lungo del nostro corpo e scorre dalla parte posteriore del bacino, attraverso i glutei, e fino in fondo ad entrambe le gambe, dunque i piedi. E’ chiaro che le cause possono essere diverse come pure la localizzazione del dolore. Cerchiamo di saperne di più.
Sintomi della sciatica
Il dolore alla sciatica (o sciatalgia) in genere si irradia dalla parte bassa della schiena e viaggia lungo la gamba fino al polpaccio: può essere di variata intensità (da lieve a grave) e durare pochi giorni o molte settimane, anche mesi. Se perdura più di 6 settimane si parla di sciatica cronica o persistente.
Il dolore dovuto al nervo sciatico è spesso confuso erroneamente con il mal di schiena, ma si tratta di due cose ben diverse: la sciatica non coinvolge la schiena tutta, ma dal bacino in giù. Il dolore tende a peggiorare nel tempo e può inoltre essere aggravato da:
- starnuti, tosse o una risata
- passare molto tempo in piedi o seduto
- piegarsi all’indietro
Spesso al dolore si associano (o ne rappresentano un’ alternativa) i seguenti disturbi alle gambe e ai piedi:
- intorpidimento
- formicolio
- debolezza muscolare
- perdita dei riflessi tendinei
Quali sono le cause della sciatica?
L’ernia del disco è solitamente considerata come la causa più comune di sciatalgia. Meno frequenti sono la stenosi spinale (caratterizzata da un restringimento delle vie nervose nella colonna vertebrale), lesioni traumatiche e non, infezioni o una crescita anomala all’interno della colonna vertebrale (tumore). C’è poi la rara ma pericolosa Sindrome della cauda equina: è caratterizzata dalla compressione o danneggiamento del fascio di nervi che si trova all’estremità del midollo spinale. Se non trattata può portare alla paralisi. Tra i sintomi iniziali di questa condizione l’improvvisa perdita di controllo della vescica e dell’intestino. Se accade questo, occorre avvisare urgentemente il medico.
Come si cura?
Nella maggior parte dei casi di sciatica acuta (ovvero a breve termine) il dolore passerà da solo senza la necessità di alcun trattamento. Contestualmente però per alleviare i sintomi sarà possibile utilizzare farmaci antidolorifici da banco (senza abusarne), e fare impacchi caldi o freddi utili a sfiammare il nervo. In presenza di una sciatica cronica invece sarebbero utili esercizi fisici strutturati con l’ausilio di un fisioterapista oltre che terapie farmacologiche sotto controllo medico: laddove i comuni antidolorifici non funzionano può essere necessario usarne altri per cui è necessaria la prescrizione, come la codeina (blando antidolorifico a base di oppiacei,) o se i sintomi sono molto gravi, un rilassante muscolare come il diazepam. In alcuni casi per risolvere definitivamente il dolore può essere necessario l’intervento chirurgico.
Sempre e comunque è importante un adeguato esercizio fisico: il riposo a letto può dare qualche sollievo temporaneo dal dolore, ma prolungare l’inattività è inutile e deleterio. Il fisico va tenuto allenato: con passeggiate ed esercizi di stretching dolce. Questo vale e soprattutto per prevenire la sciatalgia o meglio le cause che la determinano come l’ernia del disco o altre lesioni. Cosa fare?
- Migliorare la propria postura abituale e le tecniche di sollevamento degli oggetti
- stretching prima e dopo l’esercizio fisico
- semplici, regolari esercizi per migliorare la flessibilità
Fonte: NHS
Foto: Thinkstock
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